tbuckley/cabot-search huggingface dataset:
Antimicrobial-resistant gonorrhoea: the national public health response, England, 2013 to 2020
Authors: Rachel Merrick, Michelle Cole, Rachel Pitt, Qudsia Enayat, Zdravko Ivanov, Michaela Day, Suzy Sun, Katy Sinka, Neil Woodford, Hamish Mohammed, Helen Fifer
Journal: Eurosurveillance (2022)

Neisseria gonorrhoeae has developed resistance to all antimicrobials used to treat gonorrhoea, and the emergence of ceftriaxone-resistant strains threatens the last-line option for empirical treatment. The 2013 Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP) Action Plan recommended measures to delay the spread of antimicrobial resistance (AMR) in N. gonorrhoeae in England. We reviewed trends in gonococcal AMR since then and the experience of implementing the Action Plan's recommendations to respond to incidents of resistant N. gonorrhoeae. Between 2013 and 2019, diagnoses of gonorrhoea in England rose by 128% to 70,922, the largest annual number ever reported. Over this period, N. gonorrhoeae isolates have become less susceptible to azithromycin (minimum inhibitory concentration > 0.5 mg/L), increasing from 4.7% in 2016 to 8.7% in 2020; this led to a change in first-line treatment for gonorrhoea in the United Kingdom (UK) from dual therapy (ceftriaxone/azithromycin) to ceftriaxone monotherapy in 2019. We also detected the first global treatment failure for pharyngeal gonorrhoea with a dual-therapy regimen (ceftriaxone/azithromycin), followed by an additional six ceftriaxone-resistant strains. Continued engagement of sexual health clinicians and laboratories with the UK Health Security Agency (UKHSA) is essential for the timely detection of N. gonorrhoeae strains with ceftriaxone resistance and to rapidly contain transmission of these strains within England.
SARS-CoV-2 spike IgG titres up to 137 days following Comirnaty mRNA COVID-19 vaccination, Israel, February to May 2021
Authors: Tal Patalon, Shay Ben Moshe, Asaf Peretz, Ami Neuberger, Licita Schreiber, Rachel Lazar, Lia Supino-Rosin, Galit Perez, Miri Mizrahi-Reuveni, Sivan Gazit
Journal: Eurosurveillance (2022)

BackgroundData regarding the long-term protection afforded by vaccination for the SARS-CoV-2 infection are essential for allocation of scarce vaccination resources worldwide.MethodsWe conducted a retrospective cohort study aimed at studying the kinetics of IgG antibodies against SARS-CoV-2 in COVID-19-naïve patients fully vaccinated with two doses of Comirnaty mRNA COVID-19 vaccine. Geometric mean concentrations (GMCs) of antibody levels were reported. Linear models were used to assess antibody levels after full vaccination and their decline over time.ResultsThe study included 4,740 patients and 5,719 serological tests. Unadjusted GMCs peaked 28-41 days after the first dose at 10,174 AU/mL (95% CI: 9,211-11,237) and gradually decreased but remained well above the positivity cut-off. After adjusting for baseline characteristics and repeated measurements, the antibodies half-life time was 34.1 days (95% CI: 33.1-35.2), and females aged 16-39 years with no comorbidities had antibody levels of 20,613 AU/mL (95% CI: 18,526-22,934) on day 28 post-first-dose. Antibody levels were lower among males (0.736 of the level measured in females; 95% CI: 0.672-0.806), people aged 40-59 (0.729; 95% CI: 0.649-0.818) and ≥ 60 years (0.452; 95% CI: 0.398-0.513), and patients having haematological (0.241; 95% CI: 0.190-0.306) or solid malignancies (0.757; 95% CI: 0.650-0.881), chronic kidney disease with glomerular filtration rate (GFR) ≥ 30 (0.434; 95% CI: 0.354-0.532) or with GFR < 30 mL/min (0.176; 95% CI: 0.109-0.287), and immunosuppression (0.273; 95% CI: 0.235-0.317). Body mass index, cardiovascular disease, congestive heart failure, chronic obstructive pulmonary disease, diabetes and inflammatory bowel diseases were not associated with antibody levels.ConclusionsVaccination with two doses resulted in persistently high levels of antibodies (≥ cut-off of 50 AU/mL) up to 137 days post-first-dose. Risk factors for lower antibody levels were identified.
Exploring behavioural factors influencing COVID-19-specific infection prevention and control measures in Finland: a mixed-methods study, December 2020 to March 2021
Authors: Anna-Leena Lohiniva, Saija Toura, Dinah Arifulla, Jukka Ollgren, Outi Lyytikäinen
Journal: Eurosurveillance (2022)

BackgroundCompliance with infection prevention and control (IPC) measures is critical to preventing COVID-19 transmission in healthcare settings.AimTo identify and explain factors influencing compliance with COVID-19-specific IPC measures among healthcare workers (HCWs) in long-term care facilities (LTCF) in Finland.MethodsThe study included a web-based survey and qualitative study based on the Theoretical Domains Framework (TDF). The link to the anonymous survey was distributed via email to LTCFs through regional IPC experts in December 2020. Outcome was modelled using ordinary logistic regression and penalised ridge logistic regression using regrouped explanatory variables and an original, more correlated set of explanatory variables, respectively. In-depth interviews were conducted among survey participants who volunteered during January-March 2021. Data were analysed thematically using qualitative data analysis software (NVIVO12).ResultsA total of 422 HCWs from 17/20 regions responded to the survey. Three TDF domains were identified that negatively influenced IPC compliance: environmental context and resources, reinforcement and beliefs about capabilities. Twenty HCWs participated in interviews, which resulted in identification of several themes: changes in professional duties and lack of staff planning for emergencies (domain: environmental context and resources); management culture and physical absence of management (domain: reinforcement), knowledge of applying IPC measures, nature of tasks and infrastructure that supports implementation (domain: beliefs about capabilities), that explained how the domains negatively influenced their IPC behaviour.ConclusionsThis study provides insights into behavioural domains that can be used in developing evidence-based behaviour change interventions to support HCW compliance with pandemic-specific IPC measures in LTCFs.
Very low risk of monkeypox among staff and students after exposure to a confirmed case in educational settings, England, May to July 2022
Authors: Shamez N Ladhani, Felicity Aiano, David S Edwards, Samantha Perkins, Wazirzada M Khan, Nalini Iyanger, Elizabeth Whittaker, Jonathan M Cohen, David Ho, Susan Hopkins, Mary E Ramsay, J Yimmy Chow
Journal: Eurosurveillance (2022)

We investigated a secondary school (11–16 year-olds), a primary school (5–11 year-olds), reception year (4–5 year-olds) and a nursery (2–5 year-olds) following confirmed monkeypox in an adult in each educational setting during June and July 2022. MVA-BN vaccine was offered up to 14 days post exposure to 186 children &lt; 12 years and 21 were vaccinated. No secondary cases occurred among at least 340 exposed students and more than 100 exposed staff during the 28-day follow-up period.
A good death
Authors: Piotr Szawarski
Journal: BMJ (2022)

<h3>Objective:</h3> There have been few studies of the pharmacologic modulation of facial emotion recognition. The present study aimed to replicate and extend the finding that recognition of facial anger was selectively impaired by diazepam. The hypothesis was that, in comparison with placebo, diazepam would impair the recognition of facial anger in healthy volunteers, but not the recognition of 5 other basic emotions: happiness, surprise, fear, sadness and disgust. <h3>Design:</h3> A randomized, counterbalanced, double-blind, placebo-controlled, within-subjects comparison of diazepam with placebo. <h3>Setting:</h3> A university psychopharmacology research unit. <h3>Participants:</h3> Healthy male (<i>n</i> = 6) and female (<i>n</i> = 22) volunteers, aged 18–45 years. <h3>Procedures:</h3> Subjects were tested on 2 tasks following the administration of diazepam, 15 mg, and placebo on separate occasions. In the first “multimorph” task, images of facial expressions were morphed to produce continua between the neutral and full expressions of 6 basic emotions. Accuracy and identification thresholds were assessed for stimuli in which the intensity of expression gradually increased. In the second “emotional hexagon” task, facial expressions were morphed between pairs of emotions. Single images were presented, and accuracy and speed of response were assessed. <h3>Results:</h3> Diazepam produced broad impairments in response accuracy, recognition thresholds and response speed on the facial emotion tasks that were not limited to angry expressions. <h3>Conclusions:</h3> The present study found that diazepam, 15 mg, impaired facial emotion recognition, but not selectively. In the emotional hexagon task, a reaction-time analysis suggested that the identification of facial anger might be differentially sensitive to variations in stimulus duration, complicating the interpretation of this paradigm.
Preclinical interstitial lung disease in relatives of familial pulmonary fibrosis patients
Authors: S.E.M. Lucas, K. Raspin, J. Mackintosh, I. Glaspole, P.N. Reynolds, C. Chia, C. Grainge, P. Kendall, L. Troy, D.A. Schwartz, R. Wood-Baker, S.L.F. Walsh, Y. Moodley, J. Robertson, S. Macansh, E.H. Walters, D. Chambers, T.J. Corte, J.L. Dickinson
Journal: Pulmonology (2022)
Patient and provider perspectives on polygenic risk scores: implications for clinical reporting and utilization
Authors: Anna C. F. Lewis, Emma F. Perez, Anya E. R. Prince, Hana R. Flaxman, Lizbeth Gomez, Deanna G. Brockman, Paulette D. Chandler, Benjamin J. Kerman, Matthew S. Lebo, Jordan W. Smoller, Scott T. Weiss, Carrie L. Blout Zawatksy, James B. Meigs, Robert C. Green, Jason L. Vassy, Elizabeth W. Karlson
Journal: Genome Medicine (2022)

Polygenic risk scores (PRS), which offer information about genomic risk for common diseases, have been proposed for clinical implementation. The ways in which PRS information may influence a patient's health trajectory depend on how both the patient and their primary care provider (PCP) interpret and act on PRS information. We aimed to probe patient and PCP responses to PRS clinical reporting choices METHODS: Qualitative semi-structured interviews of both patients (N=25) and PCPs (N=21) exploring responses to mock PRS clinical reports of two different designs: binary and continuous representations of PRS. Many patients did not understand the numbers representing risk, with high numeracy patients being the exception. However, all the patients still understood a key takeaway that they should ask their PCP about actions to lower their disease risk. PCPs described a diverse range of heuristics they would use to interpret and act on PRS information. Three separate use cases for PRS emerged: to aid in gray-area clinical decision-making, to encourage patients to do what PCPs think patients should be doing anyway (such as exercising regularly), and to identify previously unrecognized high-risk patients. PCPs indicated that receiving "below average risk" information could be both beneficial and potentially harmful, depending on the use case. For "increased risk" patients, PCPs were favorable towards integrating PRS information into their practice, though some would only act in the presence of evidence-based guidelines. PCPs describe the report as more than a way to convey information, viewing it as something to structure the whole interaction with the patient. Both patients and PCPs preferred the continuous over the binary representation of PRS (23/25 and 17/21, respectively). We offer recommendations for the developers of PRS to consider for PRS clinical report design in the light of these patient and PCP viewpoints. PCPs saw PRS information as a natural extension of their current practice. The most pressing gap for PRS implementation is evidence for clinical utility. Careful clinical report design can help ensure that benefits are realized and harms are minimized.
Climate Change and Ambient Temperature Extremes: Association With Serious Hypoglycemia, Diabetic Ketoacidosis, and Sudden Cardiac Arrest/Ventricular Arrhythmia in People With Type 2 Diabetes
Authors: Kacie Bogar, Colleen M. Brensinger, Sean Hennessy, James H. Flory, Michelle L. Bell, Christopher Shi, Warren B. Bilker, Charles E. Leonard
Journal: Diabetes Care (2022)
Frailty in intensive care medicine must be measured, interpreted and taken into account!
Authors: Christian Jung, Bertrand Guidet, Hans Flaatten, Jesper Fjølner, Raphael Romano Bruno, Malte Kelm, Michael Beil, Sviri Sigal, Wojciech Szczeklik, Susannah Leaver, Dylan W. De Lange
Journal: Intensive Care Medicine (2022)
Department of Error
Authors: Ní Fionnuala, Saskia Áinle, Grégoire Middeldorp, Beverley Le Gal
Journal: The Lancet (2022)

clinical effi cacy.Thus, thrombolysis remains first-line treatment for patients with acute pulmonary embolism and haemodynamic instability.The shortage of thrombolytics is a reminder of the importance of venous thromboembolism prevention and highlights the mission statement of the World Thrombosis Day campaign, which is to reduce death and disability due to thrombotic conditions, both arterial and venous.In our response to this crisis, we need to ensure that patients affected by life-threatening pulmonary embolism have the same entitlement to thrombolytic agents as people affected by acute ischaemic stroke.
Real-world effectiveness of molnupiravir and nirmatrelvir plus ritonavir against mortality, hospitalisation, and in-hospital outcomes among community-dwelling, ambulatory patients with confirmed SARS-CoV-2 infection during the omicron wave in Hong Kong: an observational study
Authors: Carlos K H Wong, Ivan C H Au, Kristy T K Lau, Eric H Y Lau, Benjamin J Cowling, Gabriel M Leung
Journal: The Lancet (2022)
Doctor who plagiarised medical education theses is suspended for six months
Authors: Clare Dyer
Journal: BMJ (2022)

Hypokalaemic rhabdomyolysis represents a medical emergency requiring rapid diagnosis and appropriate aetiological treatment. Renal tubular acidosis is a common cause of hypokalemia which can be idiopathic or secondary to systemic disorders such as Sjogren9s syndrome. It can remain asymptomatic or manifest with metabolic abnormalities including hypokalemia paralysis, hypocalcaemia and hyperchloremic metabolic acidosis. Rhabdomyolysis presenting with severe hypokalemia as the first manifestation of Sjogren9s syndrome is rare. We report a case of a 59-year-old woman who presented to our department with severe weakness of all limbs. Laboratory examination demonstrated hypokalemic rhabdomyolysis caused by distal renal tubular acidosis. Investigations revealed Sjogren9s syndrome as the underlying cause of the metabolic disorders.
Enhanced cultured diversity of the mouse gut microbiota enables custom-made synthetic communities
Authors: Afrizal Afrizal, Susan A.V. Jennings, Thomas C.A. Hitch, Thomas Riedel, Marijana Basic, Atscharah Panyot, Nicole Treichel, Fabian T. Hager, Erin Oi-Yan Wong, Birger Wolter, Alina Viehof, Alexandra von Strempel, Claudia Eberl, Eva M. Buhl, Birte Abt, André Bleich, René Tolba, Lars M. Blank, William W. Navarre, Fabian Kiessling, Hans-Peter Horz, Natalia Torow, Vuk Cerovic, Bärbel Stecher, Till Strowig, Jörg Overmann, Thomas Clavel
Journal: Cell Host & Microbe (2022)

Microbiome research needs comprehensive repositories of cultured bacteria from the intestine of mammalian hosts. We expanded the mouse intestinal bacterial collection (www.dsmz.de/miBC) to 212 strains, all publicly available and taxonomically described. This includes strain-level diversity, small-sized bacteria, and previously undescribed taxa (one family, 10 genera, and 39 species). This collection enabled metagenome-educated prediction of synthetic communities (SYNs) that capture key functional differences between microbiomes, notably identifying communities associated with either resistance or susceptibility to DSS-induced colitis. Additionally, nine species were used to amend the Oligo-Mouse Microbiota (OMM)12 model, yielding the OMM19.1 model. The added strains compensated for phenotype differences between OMM12 and specific pathogen-free mice, including body composition and immune cells in the intestine and associated lymphoid tissues. Ready-to-use OMM stocks are available for future studies. In conclusion, this work improves our knowledge of gut microbiota diversity in mice and enables functional studies via the modular use of isolates.
Mucosal-homing natural killer cells are associated with aging in persons living with HIV
Authors: Kyle W. Kroll, Spandan V. Shah, Olivier A. Lucar, Thomas A. Premeaux, Cecilia M. Shikuma, Michael J. Corley, Matthew Mosher, Griffin Woolley, Scott Bowler, Lishomwa C. Ndhlovu, R. Keith Reeves
Journal: Cell Reports Medicine (2022)

Natural killer (NK) cells are critical modulators of HIV transmission and disease. Recent evidence suggests a loss of NK cell cytotoxicity during aging, yet analysis of NK cell biology and aging in people with HIV (PWH) is lacking. Herein, we perform comprehensive analyses of people aging with and without HIV to determine age-related NK phenotypic changes. Utilizing high-dimensional flow cytometry, we analyze 30 immune-related proteins on peripheral NK cells from healthy donors, PWH with viral suppression, and viremic PWH. NK cell phenotypes are dynamic across aging but change significantly in HIV and on antiretroviral drug therapy (ART). NK cells in healthy aging show increasing ⍺4β7 and decreasing CCR7 expression and a reverse phenomenon in PWH. These HIV-associated trafficking patterns could be due to NK cell recruitment to HIV reservoir formation in lymphoid tissue or failed mucosal signaling in the HIV-infected gut but appear to be tight delineators of age-related NK cell changes.
Clinical Ethics – To Compute, or Not to Compute?
Authors: Lukas J. Meier, Alice Hein, Klaus Diepold, Alena Buyx
Journal: The American Journal of Bioethics (2022)

This article refers to:Algorithms for Ethical Decision-Making in the Clinic: A Proof of ConceptAIgorithmic Ethics: A Technically Sweet Solution to a Non-ProblemAutomating Justice: An Ethical Responsibility of Computational BioethicsThe AI Needed for Ethical Decision Making Does Not ExistEthical Algorithmic Advice: Some Reasons to Pause and Think TwiceImportant Design Questions for Algorithmic Ethics ConsultationIn Search of a Mission: Artificial Intelligence in Clinical EthicsRise of the Bioethics AI: Curse or Blessing?Using Algorithms to Make Ethical Judgements: METHAD vs. the ADC ModelHow to Use AI Ethically for Ethical Decision-MakingAn All-Too-Human EnterpriseImplicit Fuzzy Specifications, Inferior to Explicit BalancingWrongful Birth: AI-Tools for Moral Decisions in Clinical Care in the Absence of Disability EthicsDisproof of Concept: Resolving Ethical Dilemmas Using Algorithms
Highly versus less bioavailable oral antibiotics in the treatment of gram-negative bloodstream infections: a propensity-matched cohort analysis
Authors: Kwadwo Mponponsuo, Kevin A. Brown, Daniel J. Fridman, Jennie Johnstone, Bradley J. Langford, Samantha M. Lee, Derek R. MacFadden, Samir N. Patel, Kevin L. Schwartz, Nick Daneman
Journal: Clinical Microbiology and Infection (2022)
Sixty seconds on . . . sponge parks
Authors: Elisabeth Mahase
Journal: BMJ (2022)

In this review, we examine the epidemiology of teenage pregnancy (girls aged 15–17 years) in the UK and consider the evidence for its impact on the health and well-being of the mother, the baby, the father and society. There has been some decrease in the teenage pregnancy rate over the last decade in the UK but rates are still considerably higher than those in other European countries. Pregnancy and childbirth during the teenage years are associated with increased risk of poorer health and well-being for both the mother and the baby, possibly reflecting the socio-economic factors that precede early pregnancy and childbirth. There is little evidence concerning the impact of teenage fatherhood on health and future studies should investigate this. The effect on society is a perpetuation of the widening gap in health and social inequalities. Public health interventions should aim to identify teenagers who are vulnerable and support those who are pregnant with evidence based interventions such as teenage antenatal clinics and access to initiatives that provide support for early parenthood.
FDA Approval Summary: Pemigatinib for Previously Treated, Unresectable Locally Advanced or Metastatic Cholangiocarcinoma with FGFR2 Fusion or Other Rearrangement
Authors: Timil H. Patel, Leigh Marcus, M. Naomi Horiba, Martha Donoghue, Somak Chatterjee, Pallavi S. Mishra-Kalyani, Robert N. Schuck, Yangbing Li, Xinyuan Zhang, Jeanne Fourie Zirkelbach, Rosane Charlab, Jiang Liu, Yuching Yang, Steven J. Lemery, Richard Pazdur, Marc R. Theoret, Lola A. Fashoyin-Aje
Journal: Clinical Cancer Research (2022)

Abstract On April 17, 2020, the FDA granted accelerated approval to pemigatinib (PEMAZYRE, Incyte Corporation) for the treatment of adults with previously treated, unresectable locally advanced or metastatic cholangiocarcinoma with an FGFR2 fusion or other rearrangement as detected by an FDA-approved test. Approval was based on FIGHT-202 (NCT02924376), a multicenter open-label single-arm trial. Efficacy was based on 107 patients with locally advanced unresectable or metastatic cholangiocarcinoma whose disease had progressed on or after at least one prior therapy and had an FGFR2 gene fusion or rearrangement. Patients received pemigatinib, 13.5 mg orally, once daily for 14 consecutive days, followed by 7 days off therapy. Safety was based on a total of 466 patients, 146 of whom had cholangiocarcinoma and received the recommended dose. Efficacy endpoints were overall response rate (ORR) and duration of response (DOR) determined by an independent review committee using RECIST 1.1. ORR was 36% (95% confidence interval: 27–45). Median DOR was 9.1 months. The most common adverse reactions were hyperphosphatemia, alopecia, diarrhea, nail toxicity, fatigue, dysgeusia, nausea, constipation, stomatitis, dry eye, dry mouth, decreased appetite, vomiting, arthralgia, abdominal pain, hypophosphatemia, back pain, and dry skin. Ocular toxicity and hyperphosphatemia are important risks of pemigatinib. The recommended dosage is 13.5 mg orally once daily for 14 consecutive days followed by 7 days off therapy in 21-day cycles. FDA also approved the FoundationOne CDX (Foundation Medicine, Inc.) as a companion diagnostic for patient selection.
Health Equity for Individuals With Intellectual and Developmental Disabilities
Authors: Kenton J. Johnston, Marshall H. Chin, Harold A. Pollack
Journal: JAMA (2022)

This Viewpoint discusses 3 types of systemic health inequity experienced by individuals with intellectual and developmental disabilities—stigma, exclusion, and devaluation of worth; underrepresentation in population epidemiology and research; and inadequate access to care and social services—and suggests potential approaches to ameliorating inequities in each of these areas.